JEANNIE M VICKERY DDS NPI 1265769780

NPI Information

NPI: 1265769780
Provider Name: JEANNIE M VICKERY, DDS
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

PECOS Registration: Yes

Address:
1121 W MICHIGAN STREET
DS307B
INDIANAPOLIS, IN
ZIP 46202
Phone: (317) 278-3632
Get Directions

Jeannie M Vickery, DDS is a prosthodontics dentist in Indianapolis, IN. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. Jeannie M Vickery, DDS NPI is 1265769780. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1121 W MICHIGAN STREET
DS307B
INDIANAPOLIS, IN
ZIP 46202-186
Phone: (317) 278-3632
Fax: (317) 274-2603

The NPI 1265769780 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/4/2009 and was last updated on 11/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0700X	Dentist	Prosthodontics	12007392A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	12007392A	OTHER		INDIANA DENTAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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